Doctor Name: | STEPHEN K KIMANI |
NPI Number: | 1023059078 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 34000020A |
Business Practice Address: | 202 Joliet St Suite 200 B Dyer, IN - 463111724 |
Business Phone Number: | 2199346410 |
Business Fax Number: | 2199346420 |
Mailing Address: | 202 Joliet St, Suite 200 B DYER |
State: | IN |
Postal Code: | 463111724 |
Phone Number: | 2199346410 |
Fax Number: | 2199346420 |
NPI Enumeration Date: | 06/09/2006 |
NPI Last Update Date: | 06/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 34000020A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |